Middlesbrough 1-0 Sunderland
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Middlesbrough have won just five league games all season
Sunderland were left on the brink of relegation from the Premier League after losing the Tees-Wear derby to fellow strugglers Middlesbrough, who registered a first victory of 2017.
Marten de Roon's goal early in a drab contest was the 59th Sunderland have conceded this season and left the Black Cats 12 points adrift of safety with five games remaining.
Sunderland face Bournemouth on Saturday and could be relegated if they fail to win and other results go against them.
The Black Cats are bottom of the league, having spent 236 days in the relegation zone, and have taken just two points from the last 27 available.
Second-bottom Middlesbrough cannot be relegated this weekend but they face a tough run-in against Manchester City, Chelsea, Southampton and Liverpool.
How could Sunderland go down?
Sunderland will be relegated at the weekend if:
They lose to Bournemouth and Hull avoid defeat at Southampton
They lose to Bournemouth and Swansea - who play on Sunday - beat Manchester United
They draw with Bournemouth and Hull win at Southampton
Sunderland fade as drop looms
Moyes rues 'poor goal' after Sunderland defeat
Sunderland boss David Moyes, who was charged by the FA prior to the game after telling BBC reporter Vicki Sparks she might "get a slap", said before kick-off he thought his side could still keep their Premier League status.
However, the on-field body language and frantic decision-making betrayed a side low on confidence.
The Black Cats started strongly, but once De Roon scored they lacked intensity, losing possession too easily to leave Moyes frustrated on the sidelines.
The defence that allowed an unmarked De Roon to ghost in and score was culpable again minutes later as Stewart Downing ran through on goal but Jordan Pickford - one of Sunderland's few bright spots this season - made the stop.
Sunderland looked slightly better going forward, with record signing Didier Ndong lashing a shot at Brad Guzan before Billy Jones headed the rebound over. However, in a tepid game where both sides struggled for rhythm, the Black Cats could not keep the pressure on for long.
The boos the Sunderland players walked off to at half-time were amplified come the end of the match, with fans chanting "you're not fit to wear the shirt".
Boro tough it out for rare win
Sunderland have won twice away from home all season and haven't won in the league since February
Middlesbrough have struggled at home this season and prior to this match had scored just 13 goals at the Riverside - the lowest of any top-flight team.
They have also played out seven goalless draws, underlining their lack of threat in the final third.
So it was perhaps no surprise they needed to profit from their opponents' carelessness to score the only goal of the game, with the unmarked De Roon sneaking in between Jones and John O'Shea before sliding the ball through Pickford's legs.
Boro looked vulnerable after going in front, with Sunderland given too much space inside the area, leading to a number of scrambled clearances.
The hosts held on, though, to end manager Steve Agnew's winless streak since taking over from the sacked Aitor Karanka in March.
The result also meant Boro striker Rudy Gestede, brought on as a late substitute, finally ended a Premier League-record run of 43 games without a win.
Man of the match - Marten de Roon (Middlesbrough)
In a tepid encounter, De Roon's alertness to Adam Clayton's lofted pass was a rare moment of quality
Boro do the double - stats
Middlesbrough have completed a league double over the Black Cats for the first time since the 2002/03 season.
Marten de Roon has scored twice in his last four Premier League appearances, as many as in his previous 26 combined.
De Roon's goal was Middlesbrough's first shot of the match.
It was Middlesbrough's first Premier League goal inside the opening 10 minutes at the Riverside since a Tuncay Sanli strike in the third minute against Hull in April 2009.
Although they were beaten, Sunderland had more shots than an opponent in an away Premier League game for the first time since April 2016 against Stoke.
Sunderland have now failed to score in 17 Premier League games this season, more than any other side.
'While there's a chance, we will keep going'
Sunderland manager David Moyes: "I've never been in this position before so it's new to me. It's something I'm not enjoying.
"We didn't get a good result but I thought we played well. It was a poor goal that we gave away but I can't fault the players or their efforts. We tried to build play up, make opportunities, but I wasn't disappointed with the performance.
"While there's a chance, we'll keep going. Good performances lead to results, that's the way it goes. I think we've had a couple of pretty good performances in the last few games.
"We know our position, we're not daft, we know exactly where we are. We have to try and pick up every win."
Boro will take on the fight - Agnew
Middlesbrough manager Steve Agnew: "It feels great. Everybody is absolutely delighted with the three points. We had to defend for long spells but we got the goal early. I'm so proud of the players.
"Clean sheets are obviously something you build on. I think it was important, the early goal. It gave everybody a lift and a confidence to see the game through.
"The players are all happy. I think all we do now is we remain focused for the game on Sunday against Manchester City. We'll certainly gain some confidence and belief going into games."
What's next?
Sunderland host Bournemouth on Saturday (15:00 BST) while Middlesbrough face Manchester City at home on Sunday (14:05 BST).